From the Neurodiagnostic Center of Louisville, KY.
Neurology. 2023 Oct 3;101(14):e1473-e1477. doi: 10.1212/WNL.0000000000207634. Epub 2023 Jul 24.
A 78-year-old nondiabetic nonsmoking man presented with a painless nonhealing ulceration on the middle fingertip of the left hand. Similar episodes occurred in the past involving the left middle and index fingers resulting in amputation of the tip of index finger. Diagnosis was deduced by clinical reasoning and confirmed by additional investigations. Readers are presented with a rational step by step diagnostic paradigm in a very rare presentation of a common neurologic disorder.
一位 78 岁的非糖尿病非吸烟男性，左手中指出现无痛性不愈合溃疡。过去也曾有类似的发作，涉及左手的中指和食指，导致食指指尖截肢。通过临床推理得出诊断，并通过进一步检查得到证实。读者将在一种常见神经疾病的罕见表现中，看到一个合理的逐步诊断范例。
